COLUMBUS, Ohio (WCMH) – Doctors are fearful that more soon-to-be mothers in Ohio could die in the post-Roe era.

The state’s maternal mortality rate is 18% higher than the national average, with 23.8 deaths per 100,000 births, according to federal data released by America’s Health Rankings. Physicians, however, caution that Ohio’s near-total abortion ban could cause the state’s “alarming” maternal health outcomes to worsen.

Hours after the U.S. Supreme Court overturned Roe v. Wade in June, Ohio enacted its six-week abortion ban, commonly called the heartbeat bill – a move that Amy Burkett, district chair of the American Chapter of Obstetricians and Gynecologists, said will endanger women.

“You take a mom … who’s maybe medically ill and has a baby that got an anomaly. Baby’s not gonna survive, but we’re putting her body at risk for a pregnancy that’s not gonna end with a happy outcome,” Burkett said. “So we’re forcing women to put their lives at risk.” 

More than 700 Ohioans died of complications related to a pregnancy from 2008 to 2019, according to the Ohio Department of Health.

Of the 731 maternal deaths, 31% were deemed pregnancy-related, with the top three causes being cardiovascular and coronary conditions, infection, and hemorrhage. The majority of deaths, 60%, were considered pregnancy-associated, with unintentional injury, homicide, and mental health conditions as the main causes.

“The longer we make people wait to have abortions, the more we make them continue pregnancies, make it hard to get out of state, make it hard to do those things, the more likely you are to have maternal morbidity and mortality,” Burkett said.

The risk of maternal death is even higher among Black women, who are two to three times more likely to die after pregnancy than white women, according to Dr. Kamilah Dixon, an OBGYN at Ohio State University Wexner Medical Center.

“Pregnancy, while it’s really exciting, it is not a benign condition,” Dixon said. “People have been getting pregnant for eons. Unfortunately, people have been dying from pregnancy for eons. We’re getting better at preventing those deaths, but they still happen.”

In a letter urging the Supreme Court to uphold Roe v. Wade, the American Public Health Association and nearly 600 public health scholars argued that 14 states with the most restrictive abortion policies, including Ohio, have the worst maternal and infant health outcomes.

Two abortion restrictions in place in Ohio – requiring licensed physicians to perform the procedure and prohibiting the use of Medicaid funds to pay for abortion – were “particularly prominent” contributors to higher maternal mortality rates, according to a September 2021 American Public Health Association report.

States with a licensed physician requirement, as opposed to allowing nurse practitioners or physician assistants to perform an abortion, had a 51% higher maternal mortality rate, as the number of abortion providers was severely reduced, the APHA found. 

States that ban the use of Medicaid funds for abortion had a 35% higher maternal mortality rate relative to states that cover the procedure under Medicaid.

Of the pregnancy-related deaths in Ohio, 59% were preventable, according to Dixon, who also serves as the medical director of Wexner Medical Center’s pregnancy program Moms2B.

Access to the right health care is one of the largest drivers in preventing pregnancy, Dixon said. She commended Ohio for boosting access by recently expanding its Medicaid coverage of postpartum care from 60 days to 12 months.

Dixon said protecting the health of pregnant women extends outside the doctor’s office.

“We know that it goes beyond the relationship you have in the exam room, right, and then after delivery, all the other components are important,” she said. “Do you have healthy food to eat? Do you have a safe place to stay? Do you have somewhere to exercise? Do you have access to mental health support?”

Burkett applauded statewide programs designed to improve maternal and infant health, like the Ohio Council to Advance Maternal Health and the home-visitation program Help Me Grow. But she said those programs can only go so far when Ohio’s six-week abortion ban deprives those with severe complications from receiving immediate, life-saving care.

“Abortion happened pre-Roe, and abortion will happen post-Dobbs,” Burkett said. “The question is, ‘How safe is it and what is it going to do to our maternal morbidity and mortality?’”